Benjamin Daniel Bradford, M.D.

Primary specialty

Facial Plastic Surgery PhysicianTaxonomy code 207YS0123X

License

22619 Issued in NV

Practice address

276 Kingsbury Grade # 101
Stateline, NV 89449-9804

Phone

(775) 588-5000

NPI assigned

May 3, 2012

Last updated

Jan 30, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 6

Addresses

Medicare fee-for-service enrollment

Enrolled in CA, NV2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

OtolaryngologyAlso: Dermatology, Plastic and Reconstructive Surgery

Education

Loma Linda University School of Medicine, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Martin E. Salm, M.D., LTD.Group PAC ID 0941219620, 3 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Merit-based Incentive Payment System (MIPS)

Final score

96.42 of 100Reported as group

Quality

93.48

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bbradford@dermasurg.emadirect.md
• Direct secure messaging: bbradford5488@direct.llu.edu
• Direct secure messaging: bbradford634923@direct.med.utah.edu

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Martin E Salm MD LTD

  • Dermatology Physician
  • Stateline, NV
  • NPI 1063595924
  Medicare reassignment Care Compare group NPD
• Tahoe Facial Plastic Surgery PLLC

  dba Tahoe Facial Plastic Surgery

  • Facial Plastic Surgery Physician
  • Carson City, NV
  • NPI 1730914433

  Dermatology

  Medicare reassignment NPD Authorized official
• Faculty Physicians and Surgeons of Llusm

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Apple Valley, CA
  • NPI 1205009917
  Medicare reassignment NPD
• Sac Health System

  dba SAC Arrowhead

  • Federally Qualified Health Center (FQHC)
  • San Bernardino, CA
  • NPI 1013935923
  Medicare reassignment NPD
• Faculty Physicians and Surgeons of Llusm

  • Family Medicine Physician
  • Moreno Valley, CA
  • NPI 1558788331
  NPD
• Faculty Physicians and Surgeons of Llusm

  • Anatomic Pathology Physician
  • Murrieta, CA
  • NPI 1588020432
  NPD
• Sac Health System

  • Federally Qualified Health Center (FQHC)
  • San Bernardino, CA
  • NPI 1467274126

  Facial Plastic Surgery

  NPD
• Sac Health System

  dba Sac San Bernardino Campus

  • Federally Qualified Health Center (FQHC)
  • San Bernardino, CA
  • NPI 1801270137

  Facial Plastic Surgery

  NPD
• Martin E. Salm, M.D., LTD

  dba Advanced Cosmetic Surgery And Dermatology

  • Dermatology Physician
  • Stateline, NV
  • NPI 1780856559
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1336003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675036800000",
    "number": "1629336128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5910",
            "city": "STATELINE",
            "state": "NV",
            "postal_code": "894495910",
            "telephone_number": "775-588-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "276 KINGSBURY GRADE # 101",
            "city": "STATELINE",
            "state": "NV",
            "postal_code": "894499804",
            "telephone_number": "775-588-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADFORD",
        "first_name": "BENJAMIN",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-03",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NV",
            "license": "22619",
            "primary": false
        },
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "CA",
            "license": "A126409",
            "primary": false
        },
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "NY",
            "license": "286986",
            "primary": false
        },
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "NV",
            "license": "22619",
            "primary": true
        },
        {
            "code": "207YX0007X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
            "state": "NV",
            "license": "22619",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "NV",
            "license": "22619",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Derek Appelblatt, DDS
• Barton Healthcare System
• Barton Healthcare System (Barton Health Rural Health Clinic - Stateline)
• Barton Healthcare System
• Dennis Doyle Bowman, D.D.S
• Steven Laurence Brooks, MD
• Patricia Anne Bucher, NP
• Jay Chung, MD
• Cosmetic Dermatology by Sean Degnan
• Sean M Degnan, M.D.

• Facial Plastic Surgery Physician in Stateline, NV
• Providers in Stateline, NV by specialty
• Facial Plastic Surgery Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.